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The only source material I can find for HIV and drug use seems to concentrate on heavy, chronic use - or the indirect impact that substance use can have on drug adherence and safer sex practices.

It would appear that heacy use of cocaine or amphetamines can indeed impact HIV progression... but to date there has been little research on occasional or recreational use of drugs and HIV. As a matter of fact, the only studies I have located that specify recreational (as opposed to heavy or chronic) drug use found no correlation between HIV progression.

Here is the long-winded article I would have summarised, but this is probably the most concise summary I can imagine, given the breadth of the study. I will post in in a seperate posting, as it exceeds the maximum length of a post.

"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

Recreational drug useNearly every person with HIV uses some form of drug. Most people use legal drugs like coffee, tea or chocolate, and many others drink alcohol or smoke tobacco. A large number of people with HIV also use illegal drugs.

In this section, information is provided on alcohol, tobacco and so-called recreational drugs.

Drugs and the lawFor the very latest information on the adverse effects and legal status of drugs, you might want to look at the website of the UK drugs information charity Drugscope, www.drugscope.org.uk.

Generally, drugs in the UK are controlled by two laws: the Medicines Act and the Misuse of Drugs Act. The Medicines Act bans the non-medical use of some licensed pharmaceuticals. The Misuse of Drugs Act is concerned with the use of banned drugs, which are placed into different categories. Offences involving Class A drugs carry the stiffest penalties, and offences involving Class C drugs the lightest. A first offence involving possession of drugs is likely to involve a fine or caution. But this would mean that you have a criminal record. Regular offenders, and people who sell or smuggle drugs, can expect to face a prison sentence, and having HIV is unlikely to mean that the courts will deal with you more leniently.

AlcoholAlcohol is a drug and comes in many forms, including beer, cider, wine, ‘alcopops' and spirits such as whisky, gin and vodka.

Alcohol is legally available in the UK from licensed outlets to people aged over 18 years and is enjoyed and used safely by many people. However, alcohol is a major cause of health and social problems, and, after tobacco, causes more deaths in the UK than any other drug.

Alcohol relaxes the brain and body, and is normally drunk for its pleasant effects. Because of its power to alter mood and make physical changes, it can also lead to physical, psychological and social problems. Many people find that moderate drinking (a unit or two of alcohol per day) helps relieve stress, encourages relaxation and acts as an appetite stimulant. A unit of alcohol is equal to a half-pint of normal strength beer or lager, a pub measure of spirits, a glass of wine, or a small glass of sherry or port.

Health agencies recommend that men should not drink more than 3 to 4 units of alcohol per day. For women, the daily limit is 2 to 3 units. This advice applies regardless of whether you drink daily, weekly or somewhere in between. Drinking all your weekly limit in one session (often called binge drinking) can lead to poor coordination, vomiting, exaggerated emotional reactions (including sadness, tearfulness, anger and aggression) and can even cause unconsciousness. Women who are pregnant, or planning to become so, are advised to drink no more than 1 to 2 units per week.

A hangover the next day – headache, dry mouth, feeling sick and tired – is a very common consequence of heavy drinking the night before. These effects are caused by dehydration and toxicities, so if you drink alcohol, you should drink plenty of water as well.

As even small amounts of alcohol can have an effect on your coordination, reactions and judgments, you should never drink even small amounts of alcohol and then drive or operate machinery.

Extremely heavy drinking can lead to coma and even death.

Long-term heavy alcohol consumption (10 or more units a day in a man or 6 or more in a woman) can cause ill health, affecting the liver, heart and brain. Drinking every day can also lead to physical and psychological dependence on alcohol.

In addition, people who drink heavily often don't eat well and this can cause further health problems. Alcohol is a depressive drug and can cause or make worse mental, psychological or emotional problems. Used in conjunction with other drugs, such as over-the-counter painkillers like paracetamol, alcohol can have more serious effects.

There is no evidence that moderate drinking (a unit or two of alcohol a day) does any harm to people with HIV. However, if you have hepatitis or high levels of blood fats, then you may have to cut down your alcohol consumption or stop drinking alcohol altogether.

Heavy drinking can affect your immune system and may slow down recovery from infections.

Heavy alcohol use can have potentially serious consequences for people taking anti-HIV drugs. Alcohol is processed by the liver and a healthy liver is necessary for the body to process medicines effectively. The blood fat increases caused by some anti-HIV drugs can be made worse by heavy drinking.

People who have hepatitis as well as HIV are advised not to drink alcohol at all, or to keep alcohol consumption to an absolute minimum.

People whose liver has been damaged by drinking too much alcohol (especially if they have hepatitis) are more likely to experience side-effects from anti-HIV drugs, particularly protease inhibitors.

Alcohol can react badly with certain medicines (for example some anti-TB drugs and some antibiotics) so it is a good idea to check with your pharmacist whether it is safe to drink alcohol with any new medicines you may be prescribed. However, there is no significant interaction between any of the currently available anti-HIV drugs and alcohol.

Alcohol can cause vomiting. If you vomit within an hour of taking a dose of your anti-HIV drugs, or any other medicine you have been told to take, you should retake the dose.

If you are concerned about your drinking, speak to a member of your healthcare team, who will be able to direct you to somebody who can help. Alcohol Concern, one of the UK's largest alcohol charities, can be contacted via www.alcoholconcern.org.uk, or phone Drinkline on 0800 917 8282. More information on Scottish support services is online at www.alcohol-focus-scotland.org.uk, or phone 0141 576 6700.

Amphetamines (speed)Also see the section on crystal meth below

Amphetamines are stimulants normally taken orally, although they can be dissolved in water, snorted, or injected. After cannabis, amphetamines are the most widely used illicit drug in the UK, and are classified as a Class B drug in the Misuse of Drugs Act, unless they are prepared for injection, when they are Class A.

Amphetamines cause the heart rate to increase, appetite to diminish, mood to improve, and the pupils to dilate. Users often report a 'rush' of confidence lasting three or four hours before they begin to 'come down'. Feelings of anxiety and agitation take over from this point. Repeated use of amphetamines can lead to tolerance of the drug, meaning that you have to take more to achieve a 'high'. Symptoms of anxiety, paranoia and panic can also set in. Prolonged and heavy use can lead to mental disturbances.

Amphetamine use postpones, but does not remove, the need to eat. Regular users often suffer from weight loss and malnutrition. This reduces the body’s ability to fight infection, and this is a major concern for people with HIV.

There is no clear evidence that HIV-positive users of amphetamine experience faster disease progression, but see the section on crystal meth (methamphetamine).

Anabolic steroidsAnabolic steroids are hormones which are commonly used as drugs to build muscle mass. Body builders and, increasingly, regular gym users often use anabolic steroids in four-week cycles, to improve the effects of their training.

HIV-positive men are sometimes prescribed anabolic steroids or testosterone replacement therapy if they have low natural levels of testosterone or have lost a lot of lean muscle mass.

Steroids can be highly toxic to the liver, and can also cause acne, male pattern baldness, sexual problems and shrinking of the testicles. Women who use anabolic steroids can develop masculine characteristics.

Steroids bought at gyms are often counterfeit or contaminated in some way and can be particularly toxic to the liver and cause nerve damage.

There is controversy about the effect of anabolic steroids on the immune system. Some researchers have argued that they are immunosuppressive, but a study looking at the immune systems of HIV-positive men given prescribed steroid treatment for wasting showed that they did not suppress the immune system. However, it is known that steroid use can increase levels of LDL (bad) cholesterol, so they should be used with extreme caution and under close medical supervision if you have raised blood fats due to your anti-HIV medication.

Needle-sharing by steroid users carries exactly the same risk of HIV transmission as needle-sharing for recreational drug use.

Barbiturates (downers)Barbiturates are used medically, to calm people down and as sleeping pills. Barbiturates are a prescription-only drug and are classified as a Class B drug if they are used illicitly. Possession is not, however, a criminal offence.

Barbiturates affect the central nervous system, causing a clammy feeling, and depending on the dose, the effects last between three and six hours. They can cause clumsiness, happiness and mental confusion – and unhappiness can also be caused by barbiturates.

Large doses can cause unconsciousness, breathing problems and death. Death from overdose is a very real danger, as there is a fine line between a safe and a dangerous dose. The chances of overdose are increased if barbiturates are taken with alcohol. The risks of barbiturate use are increased if the drug is injected.

The body can rapidly become tolerant of barbiturates, leading to both physical and mental dependence. Withdrawal can involve symptoms of irritability, sleeplessness, sickness, twitching, convulsions and delirium.

Heavy users are more vulnerable to chest complaints and hypothermia.

(Continued)

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"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

CannabisThe legal status of cannabis changed recently in the UK, when the drug was reclassified from Class B to Class C.

Cannabis can be smoked, usually with tobacco, eaten, drunk in a ‘tea' or snorted as a snuff. The drug affects the central nervous system and, as a result, users may experience relief from pain, feel light-headed, relaxed or sleepy. The drug can also stimulate appetite; the so-called ‘munchies'. However, cannabis is also known to impair co-ordination, and can cause nausea and vomiting as well as anxiety and paranoia, which, with long-term use, may become chronic.

Medicinal use of cannabis is illegal and therefore there is little verifiable evidence of the drug's effects when used in the management of chronic health conditions. However, cannabis is widely used illegally for medicinal reasons, often for the relief of pain or as an appetite stimulant. In 1996, a clinical trial in San Francisco found that people with HIV wasting disease who used cannabis were more likely to put on weight. The drug is also widely used to relieve insomnia and the symptoms of anxiety and stress. It is also used by people with multiple sclerosis as a muscle relaxant.

In recent years a small number of people have been prosecuted for growing and consuming cannabis for medicinal purposes. In most cases a suspended sentence has been issued, but recently a jury returned a not guilty verdict, and in another example a judge threw out the case.

The UK Government is currently reviewing the evidence on cannabis use. Cannabis extracts, called cannabinoids, are already legally used in licensed pharmaceuticals, mostly painkillers and muscle relaxants, but these can only be obtained on prescription. These products do not make users feel ‘high' or have any of the other narcotic effects of cannabis.

Short-term risks of cannabis use include anxiety, panic, and paranoia. Memory and attention may also be affected, as might the ability to drive or operate machinery. Research suggests that cannabis use in teenagers is a predictor of later mental health problems. Use during pregnancy has been associated with low birth-weight babies.

If the drug is smoked, long-term use is known to cause many smoking-related respiratory and cardiovascular diseases such as asthma, bronchitis, emphysema and heart disease. This may be of particular concern to people with HIV who have suffered lung damage from TB, or to those with increased lipids from anti-HIV medication, as this may increase the risk of heart attack. There is also evidence that smoking cannabis can cause cancers of the mouth, throat and lungs.

Chronic loss of memory and shortened attention span have been observed in long-term users of the drug, in some cases even after their use has ceased, and there is evidence that long-term users can develop psychological dependency on the drug. In a recent survey, daily use of cannabis by teenagers was found to substantially increase the risk of developing depression later in life and the use of cannabis has also been linked with an increased risk of schizophrenia.

It is not known how cannabis reacts with anti-HIV drugs. A small American study found that cannabis use did not impact on the effectiveness of the protease inhibitor indinavir (Crixivan), even though the drugs use the same mechanism to pass through the body. Like any mood- or consciousness-altering drug, cannabis may have an impact on people's ability to adhere to their medication schedule. People planning to use cannabis, or any other recreational drug, may need to develop strategies to help them take their medication at the right time and in the right way.

CocaineAlong with most other recreational drugs, government statistics suggest that more people are using cocaine (coke, charlie, snow, powder, marching powder) and the cocaine derivative, crack (freebase). In the UK, both cocaine and crack are illegal class A drugs. Dealing carries a maximum penalty of life imprisonment and unlimited fine, and possession can mean up to seven years in prison and a large fine.

Cocaine is a stimulant made from the leaves of the South American coca shrub. It comes in the form of a white powder, costing between £30 and £100 per gram. Usually snorted into the nose, it provides a feeling of excitement, exhilaration and self-confidence lasting for about 15-30 minutes. Cocaine can also be rubbed into the gums and into the anus or vagina before penetrative sex. Rarely, cocaine is also made into a solution for injection.

Crack is sold in the form of small rocks, which are smoked either in cigarettes or in a pipe. Historically, crack has been associated with poor urban populations, but is in fact used by people from a wide social spectrum.

Cocaine users may take many doses to maintain the high, which can cause anxiety, paranoia and a tolerance for the drug, meaning that larger doses have to be taken to achieve a similar high. Although not addictive in the same way as heroin or opiates, users can become psychologically dependent on the transient high which cocaine provides and find that they suffer anxiety, depression or severe tiredness if they stop using the drug.

Longer-term use of both cocaine and crack can cause severe anxiety, clinical depression, psychotic episodes, aggression, weight loss and malnutrition. Both drugs have also been shown to cause potentially fatal heart problems including heart attack, angina, irregular heart beat and inflammation and enlargement of the heart.

In common with most other street drugs, users are rarely sold a pure form of cocaine. The drug is often ‘cut' with other cheaper drugs such as amphetamines (speed), talc or detergents, which can be poisonous or cause irritation, leading to infection.

Snorting cocaine can damage the membrane between the nostrils, leading to bleeding and eventual erosion. There have been reports that sharing snorting equipment may permit the transmission of hepatitis C virus. Rubbing cocaine into the gums, vagina, or anus can cause ulceration, which could increase transmission of HIV or other sexually transmitted infections. Sharing injecting equipment also presents a risk for transmission of HIV, hepatitis viruses and other blood-borne infections.

Cocaine is not metabolised by the body in the same way as anti-HIV drugs, so there does not appear to be cause for concern about interactions between them.

Test-tube studies suggest that cocaine alters the functioning of the immune system in several ways, making immune cells more vulnerable to HIV. Experiments conducted in HIV-infected mice bred in laboratories found that mice exposed to cocaine had far fewer CD4 cells than mice not given the drug. This suggests that HIV disease may progress faster in regular cocaine users.

However, studies looking at regular cocaine use and disease progression in gay men have produced conflicting results. One study found no association, whilst another found that weekly cocaine use was associated with a greater risk of death. Because drug use may be an indicator of other social issues which may have a negative effect on health – such as poor access to health care, or other health problems – these types of studies can be difficult to interpret.

As with all recreational drugs, it is also wise to consider how use could impact on adherence to your HIV treatments. If you are worried about your recreational drug use, then your doctor or health care team will be able to refer you to an appropriate source of support.

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"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

Crystal meth (methamphetamine)Also know as crystal meth, ice, tina, krank, or yaba, methamphetamine is a synthetic form of amphetamine, a stimulant drug.

Crystal meth has been popular on the US gay scene for over a decade, and there have been some alarmist reports about its use amongst gay men in the UK and Europe. However, it is unclear just how widespread use of the drug, which is very expensive and difficult to obtain, actually is.

Methamphetamine is a class A drug.

Methamphetamine can be bought as a pill, as powder to be snorted through the nose or injected, or in a crystal form – ice – which is smoked in a pipe.

Methamphetamine brings on a rapid feeling of exhilaration, a perceived sharpening of focus and heightened sexual desire.

There is anecdotal evidence that use of methamphetamine can cause people to become ill because of HIV more rapidly, to take more time to recover from infections and to respond less well to anti-HIV treatments. However, some people believe that this has a lot to do with users of the drug not taking their anti-HIV and other medication properly.

Rapid fall in CD4 cell count has been observed in methamphetamine users. However, as many users of methamphetamine have difficulty sleeping or eating properly, there may be other lifestyle factors involved in the quicker disease progression noted in some users.

Psychological dependence on the drug has also been reported, although it does not seem to cause physical addiction.

Taking large amounts of the drug can cause convulsions, problems with blood circulation, inability to breath, coma and death. However, deaths have been reported in people who have taken only small doses.

In the US there have been concerns about a link between the use of methamphetamine by gay men and unprotected sex, particularly when used in conjunction with drugs to treat erectile dysfunction, such as Viagra and Cialis.

There has been a case report of an interaction between methamphetamine and the protease inhibitor ritonavir (Norvir). Methamphetamine is metabolised by the body using the same mechanism as ritonavir. Doctors also believe that inhaling poppers may make the interaction worse.

The use of any drug can interfere with normal sleeping patterns, affect appetite and interrupt routines. Some people have found that this is particularly the case with methamphetamine. If you are using the drug, it makes sense to consider how it might affect issues such as adherence to your anti-HIV medication. The drug has also been linked with an increased likelihood of having unprotected sex, so plan how to manage this.

EcstasyEcstasy (E, X) is an illegal class A drug. Dealing carries a maximum life prison sentence and unlimited fine, and possession up to seven years in prison and a £5,000 fine.

Ecstasy has both stimulant and hallucinogenic properties. Its active ingredient is a synthetic drug called MDMA. Originally used in psychotherapy, from the late 1970s it started to be used on the club scene due to its ability to reduce inhibitions, give an energy boost, induce relaxation and give intense pleasure by releasing the neurotransmitter serotonin.

The drug is sold in tablet form and, less frequently, as a powder. After about 30 to 45 minutes, the drug gives an intense ‘high', which may last for several hours. Because the body becomes tolerant of the drug, people may end up taking larger quantities to induce similar feelings of euphoria.

Because ecstasy is illegal there have been no proper clinical trials looking at the risks of using the drug for people with HIV. The effects of ecstasy on the immune system and on HIV disease progression are therefore uncertain.

In 1996, a man who had recently started taking a combination of anti-HIV drugs, including the protease inhibitor ritonavir (Norvir), died after taking two and a half ecstasy tablets. An autopsy found that there was an unusually high amount of ecstasy in his blood, which may be partly explained by an interaction between the drug and ritonavir. Ritonavir boosts the amount of ecstasy in the bloodstream by between 200% and 300%, because the body uses the same process to break down both ritonavir and ecstasy.

Because other protease inhibitors (and NNRTIs and many other drugs) are metabolised using a similar process, there is a risk that ecstasy could interact dangerously with them, and there have been hospitalisations due to adverse reactions to ecstasy amongst people taking protease inhibitors.

If you've started a new treatment combination recently, the first four weeks, when your body gets used to the new drugs, are likely to be the riskiest time for interactions. Some doctors suggest that after this period, if you choose to take ecstasy, it may be safer to begin with a quarter or half a tablet first. This information is included here in order to help readers reduce risks, and has not been researched scientifically.

As with all recreational drugs, it is difficult to know what the ecstasy tablet you are using really contains. The doses found in street drugs are not controlled, and the ecstasy pill you buy might contain much larger quantities of the drug. Often, ecstasy will have been ‘cut' with other substances which could be poisonous, or with other drugs, usually amphetamines or LSD, but occasionally heroin.

In the short term, ecstasy can cause dehydration, headache, chills, eye twitching, jaw clenching, blurred vision, nausea and vomiting and, like many drugs taken to get ‘high', is commonly accompanied by a ‘come-down'.

People can have an allergic reaction to the drug, which can be fatal (though deaths related to ecstasy are very rare in comparison to the extent of its consumption). The drug has also been associated with heart and lung problems, dramatic increases in body temperature, kidney failure and liver damage. The potential liver toxicities of ecstasy and other recreational drugs are of particular concern to people with HIV, as liver damage can itself make you very ill as well as stopping the body from processing anti-HIV drugs properly.

Long-term use has been linked to poor mental health, depression, psychotic episodes and memory problems.

If you are using ecstasy or planning to do so, then think about discussing this with your doctor or another member of your health care team. Most are quite happy to discuss drug use and can provide helpful information on minimising risks.

As with all recreational drugs, it is wise to consider how use could impact on adherence to your HIV treatments or other areas of your health or life.

GHBGHB (gammahydroxybutyrate) has recently become popular on the club scene, with users reporting an alcohol-like high with potent positive sexual effects. However, its possession and use recently became illegal after a series of deaths were associated with its use.

GHB affects the release of dopamine in the brain, causing effects ranging from relaxation to deep sleep, and coma. The drug also lowers blood pressure and can cause breathing difficulties.

A case has been reported in which levels of GHB were increased to life-threatening levels when taken along with a protease inhibitor. A man who was taking ritonavir and saquinavir became deeply unconscious after taking a half-teaspoon of GHB. Doctors believe that the ritonavir and saquinavir slowed down the metabolism of GHB and caused a near-fatal reaction.

HeroinSee opiates

KetamineKetamine is an anaesthetic which makes people feel detached from their immediate environment.

Since early 2006 possession of ketamine has been a crime. It comes in a white powder which can be snorted, dissolved or injected. It normally takes effect after about 20 minutes. The body heats up and users have reported a range of different experiences including an altered sense of their body, hallucinations, difficulty moving or even completely freezing. This is often called a 'K-hole', and involves difficulty communicating and even breathing and swallowing.

The effects of long-term ketamine use include memory loss and psychological disturbance. Several deaths have been reported due to the use of the drug in the UK. Although no specific interactions with anti-HIV medication have been reported, use of the drug could affect adherence to anti-HIV medication.

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"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

http://www.aidsmap.com/cms1044114.aspLSDLSD (lysergic acid diethylamide, often known as acid) is a Class A drug. It is taken orally and normally begins to take effect after about 30 to 60 minutes. Its hallucinogenic effects last up to eight hours, although some people report “trips” lasting as long as 24 hours.

LSD is not thought to affect the immune system and no specific interactions with anti-HIV drugs have been reported. However, when “tripping” on acid adherence to anti-HIV medication might be difficult or even impossible.

OpiatesThese include heroin and methadone and are made from the opium poppy. Heroin is a Class A drug. Methadone is controlled by the Medicines Act.

Opiates are normally injected, smoked or sniffed. They depress the nervous system and have a euphoric effect. Tolerance of opiates develops quickly, as does dependence.

Use of opiates can cause chest problems and constipation. Sharing the equipment used to inject opiates can lead to infection with tetanus, hepatitis B and C, HIV, and can cause blood poisoning and abscesses.

Use of opiates can lead to malnutrition and self-neglect.

Methadone is a form of opiate normally supplied on prescription to registered addicts as an alternative to injecting. It is usually taken as a liquid. To withdraw from opiate use, addicts can gradually reduce their dose of methadone over a long period of time.

Methadone interacts with anti-HIV drugs. The drug is known to increase levels of AZT (zidovudine, Retrovir) in the blood. Doctors are often very cautious about giving protease inhibitors to people taking methadone, and will often admit them to hospital for observation for a short time. The protease inhibitor nelfinavir (Viracept) reduces methadone levels. The NNRTIs have differing effects on methadone levels. Nevirapine (Viramune) increases levels of methadone, whereas efavirenz (Sustiva) reduces levels of methadone, particularly in the early stages of treatment.

There is conflicting evidence about the effect of using opiates on HIV disease progression, with some studies finding that heroin users progressed to AIDS and death faster, while others did not. Since the advent of anti-HIV treatments, some evidence has emerged that opiate users become resistant to their anti-HIV drugs faster, probably due to poor adherence.

PoppersPoppers are a nitrite-based drug. Amyl nitrite is used medically to ease the chest pain caused by angina. The drug gets its name from the small glass capsules containing amyl nitrite for the treatment of angina which used to be ‘popped’ under the nose and inhaled. Amyl and butyl nitrite started to be used recreationally, and have been popular with gay men for many years. More recently, they have become popular with clubbers of all sexualities.

The long-term effects of poppers have been a matter of considerable controversy, particularly as it has been argued that their use caused AIDS and particularly Kaposi’s sarcoma. However, this view is not supported by any scientific evidence and studies comparing the effects of poppers on HIV-negative and HIV-positive gay men found that only those with HIV suffered any immune damage or progressed to AIDS. However, some animal studies have shown that poppers can suppress immune responses and can have cancer-causing effects. These studies have been criticised because of the relatively large amounts of nitrites given to animals. Any long-term immune damage or cancer-causing effect in humans remains to be proven.

There are no documented interactions between drugs used to treat HIV and poppers. However, sniffing poppers after taking the anti-impotence drugs Viagra and Cialis can result in a potentially dangerous, even fatal, drop in blood pressure. The dangers from sniffing poppers after taking Viagra or Cialis are increased if you are also taking a protease inhibitor as part of your HIV treatments. Protease inhibitors cause the amount of Viagra or Cialis in the blood to increase, and for this reason it is recommended that people prescribed protease inhibitors take only half the normal dose of Viagra or Cialis and do not use poppers at the same time.

As with any drug, it may be wise to consider how using poppers affects your wider health and lifestyle, particularly if you are using poppers with other drugs or alcohol. Some people report that using poppers may act as a trigger for unprotected sex and, if this is the case for you, you may wish to have a strategy in place to help you manage this.

Sexual dysfunction drugsViagra (sidenafil citrate), Cialis (tadalafil) and Levitra (vardenafil) are treatments for erectile dysfunction which have become increasingly popular as recreational drugs, particularly amongst gay men, many of whom use the drug to counteract the impotence side-effect of other recreational drugs such as ecstasy. Several studies have linked use of Viagra and Cialis with increases in the amount of unprotected sex gay men are having and increased rates of sexually transmitted infections. However, it is unclear if this is because the use of these drugs enables men to have more sexual partners or just increases the amount of sex they are having. It’s also possible that men just add the use of anti-impotence drugs to their existing risk-taking repertoire.

The most common side-effect of these anti-impotence drugs is headache. Viagra, Cialis and Levitra should not be used in conjunction with poppers, as this could cause a potentially dangerous drop in blood pressure.

Protease inhibitors and NNRTIs are metabolised by the body using the same method as Viagra,Cialis and Levitra, and this can mean that you get very high levels of anti-impotence drugs in your blood, increasing the chances and severity of side-effects. For this reason, you are recommended to reduce by half the standard dose of both Viagra, Cialis and Levitra if you are taking either protease inhibitors or NNRTIs, and not to take more than a single standard dose of either of these impotence drugs in a 48-hour period.

SmokingTobacco is a legal and widely used drug. However, smoking is addictive and it is beyond any doubt that smoking can severely damage health and cause early death. HIV-positive smokers may be more likely to get certain AIDS-defining illnesses if they have a weak immune system, and be at increased risk of developing the metabolic side-effects caused by some anti-HIV drugs.

Smoking, in itself, does not make HIV infection worse. The rate at which HIV disease progresses, or at which CD4 cells are lost, is no greater in smokers than non-smokers. Anti-HIV medication is just as effective in smokers as non-smokers.

However, there is very good evidence that people with HIV who smoke are more likely to get certain infections and AIDS-defining illnesses, particularly those affecting the chest. It’s known that smokers are approximately three times more likely than non-smokers to develop the AIDS-defining pneumonia PCP. Oral thrush, a common complaint in people with HIV, is also more common amongst smokers.

Emphysema, a smoking-related illness, occurs much more commonly in HIV-positive smokers than HIV-negative smokers.

It’s well known that smoking increases the risk of heart disease, high blood pressure, and stroke. It’s thought that having a long-term illness like HIV might increase the risk of heart disease. Further, some anti-HIV drugs can cause increases in blood fats, and this can contribute to cardiovascular illnesses. If you smoke and take anti-HIV drugs, then your risks might be increased even further.

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"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

Sorry about those long posts. I felt the need to be thorough and do as little editing as possible, as this appears to be a rather incendiary issue among some people.

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"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

The biggest danger isn't so much the drug itself, it's what happens when you are on it: dehydration, not eating regularly, and ABOVE ALL not staying on your HAART routine. If you are a mature, responsible individual who is able to be MODERATE and not a mess on drugs then you can somewhat dabble in the stuff. Doing your HIV meds at the same time is the big deal -- if you can't do both you eliminate the recreation.

If you are a person who tends to be compulsive, does not know their limits, and would get addicted to dust on a kitchen table if that was possible then NO, do not do drugs while infected with HIV. This is why I always advise against the heavy duty drugs like meth and heroin -- I consider their addiction abilities equal and above most other drugs, and they're something you have to commit to for such a long duration that the chances of skipping HAART doses is too risky.

Normal caveats apply just like with eating sushi: the lower your cd4's the less wiggle room you with such things, or that is how I would approach it.

Anyway, that's my $.02 I'm sure the usual poster on this web board who's emotionally obsessive with both this issue and me will do his usual song & dance.

I only had time to read the other two articles, seems like you spend alot of time researching this topic. Glad you provided us with this. I am sure it will make many of those people who have done or are doing illicit drugs better and encourging.

Caffeinne, nicotene, alcohol are all factored in the mix here. I neither advocate nor discourage drug use because frankly, it isn't my business. It is no secret that I use an illegal drug on occasion, mostly to help achieve REM sleep or as a method of pain/nausea management.

Thing is, it's far too easy to put a blanket condemnation on ALL drug use, when the science simply does not support such a broad brush.

And to be fair, I spend a fair amount of time researching most of the stuff I post, from transmission vectors to testing windows to re/superinfection and other STD issues.

Me likee the science.

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"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

One thing my first doctor said was if you're going to smoke pot, use a bong. That way you are not treating your lungs to as harsh and hot a smoke as using it from a reefer. I don't smoke pot very often, and never have. Makes me paranoid!

That said, someone on this board made the claim a few weeks ago that "It is said that one hit ecstasy can lower your cd4 count by the hundreds" and I'd love to see the link to that little nugget of scientific wisdom.

Thing is, it's far too easy to put a blanket condemnation on ALL drug use, when the science simply does not support such a broad brush.

It is. It's a singular and curious fact about our society that it's OK to pump children full of speed to make them pay attention in school, and treat millions of people's depression with cocaine derivatives, as well as use benzo drugs for anxiety... but society views someone who uses "illicit" drugs, even responsibly, as scum.

I'll never quite understand it.

There's a certain degree of cognitive dissonance flying in the face of all the facts.

My doctor said the same thing about pot. But he added the caveat that bong smoking does not deliver the amount of THC that direct contact did. So I would be smoking MORE to get the desired effect through a bong.

But it has had a significant positive impact on my ability to get restful sleep on the nights I use it - Which, ot be fair, is not even eveyr other night.... I just get really wary of being addicted to prescription sleep meds, and I have never responded well to anti nausea meds

I suppose the ten thousand dollar question is, what constitutes recreational use as opposed to heavy/chronic/addictive use? I imagine that answer differs from drug to drug, from person to person.

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"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

Marijuana I don't even consider a "drug" -- it's organic and it should be legal. Plus you can make wonderful clothing from hemp. I have a really nice hemp and linen peach color shirt.

I wasn't aware that bong delivers less THC than smoking rolled up in paper. Why don't you just make brownies?

I feel bad you going through all this shit Jonathan, even though we've never spoke I've followed along. Nausea sucks, though I've somehow managed to avoid it for 15 years. Did you check into the tincture of opium?

I would love the brownies, except it takes a quarter bag for a pan of them. Fifty dollar brownies? They'd better have Hershey's Kisses in them.

I know eating them is best, but JEEZ it's pricey.

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"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

What ever delivers the most THC value for the dollar, that's all I was asking. Plus you get to EAT something, and you're having weight issues/appetite no? Anyway, $50 brownies is just so designerish... so "very"!

"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

I would love the brownies, except it takes a quarter bag for a pan of them. Fifty dollar brownies? They'd better have Hershey's Kisses in them.

I know eating them is best, but JEEZ it's pricey.

You'll get more bang for your buck if you saute the herbs in butter (or what ever fat your recipe calls for) FIRST, before adding it to the mix and baking it. You need heat to release the THC and baking doesn't always do a thorough job.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

I suppose the ten thousand dollar question is, what constitutes recreational use as opposed to heavy/chronic/addictive use? I imagine that answer differs from drug to drug, from person to person.

Ah, yes -- that really is the question isn't it! The unfortunate thing is, that most folks can't really tell when they cross that line -- and it usually takes some "bad" happenings to get them to even think they may have crossed it. I know it took me 2 DUI arrests before I thought maybe the problem was with my drinking (fortunately NO ONE got hurt or killed by my inability to see the light). I haven't drank (or used any other "illicit" drugs) since 1989 -- and everyone is better off for that!!!

Unfortunately the "bad happening" for some may be poor adherence and unnecessary health issues.

Of course, I do agree that it is an individuals choice and that many people are able to do things in moderation, so blankets don't really apply, but one does have to be cognizant of the risks they are taking.

I'm completely against the use of drugs; and I assert that they definitely do speed along death and diseases for HIV positive people. The one thing I advise all poz people I meet to do is to stay away from drugs and excessive drinking!! Four friends died this past year of complications from AIDS, they were all "partyers", drinking and drugging too much of the time. It makes me so sad! What a waste of time!

I'm completely against the use of drugs; and I assert that they definitely do speed along death and diseases for HIV positive people. The one thing I advise all poz people I meet to do is to stay away from drugs and excessive drinking!! Four friends died this past year of complications from AIDS, they were all "partyers", drinking and drugging too much of the time. It makes me so sad! What a waste of time!

It's all about moderation. I asked my doctors about this, who are very realistic about the fact that a lot of gay men take drugs, and they said that if you had wild drug taking every week or if it affected adherence then obviously it can have a negative effect. But please don't try and tell me that a couple of ecstasy pills every month or whatever will kill me.

i am a new positive and i have cd4-851 (37%) and vl - 9890 my doc said that i dont need to take med for now. i wanna know if i taking ecstasy or special k can b more harmfull for me then if i were negetive. i know that taking these things while taking drugs 4 hiv is dangeruse. but im not taking drugs yet. shuold i stop using ecstasy or special k?

Response from Dr. Frascino

Hello Israeli Guy,

You are correct: using club drugs, like ecstasy or special K, while on HIV medications is indeed very dangerous, due to drug interactions.

Is taking these drugs "more harmful" because you are HIV positive if you are not on HAART yet? Your question, as stated, implies club drugs are harmful whether or not you are HIV positive. Once again, I concur. Are they "more harmful" just because you're positive is difficult to answer. Since these drugs are illegal and also since it would be unethical to conduct a clinical trial on just how harmful (or more harmful) they are in HIV-positive folks, I cannot give you a direct answer, other than to say they are unquestionably harmful.

Ecstasy is an amphetamine with both stimulant and hallucinogenic properties. It increases heart rate, blood pressure and consumption of oxygen by the heart muscle. It increases the risk of dehydration, seizures, kidney failure, heart failure and death. Regular use causes lasting damage to brain cells, resulting in impaired memory, disrupted sleep, depression and anxiety.

Special K is ketamine, a short-acting general anesthetic often used in veterinary medicine. It causes dreamlike hallucinatory effects. Low doses produce a mellow, colorful experience, whereas higher doses create an "out of body" or "near death" experience, loss of consciousness, delirium, amnesia, seizures and even, in some cases, fatal respiratory collapse. When combined with alcohol, there is a risk of falling asleep or collapsing, and then vomiting and possibly choking on one's own vomit.

Should you stop using ecstasy or special K? Yes, I would definitely stop, whether or not you are HIV infected. The ultimate decision is yours; however, your chances of successfully coexisting with HIV are significantly decreased if you choose to continue using.

It actually makes sense. There is little research done and not much evidence to prove that being on HAART and taking illegals substances can affect their counts because it is considered unethical. Perhaps that is why not much information can be found about proving this.

I'm completely against the use of drugs; and I assert that they definitely do speed along death and diseases for HIV positive people. The one thing I advise all poz people I meet to do is to stay away from drugs and excessive drinking!! Four friends died this past year of complications from AIDS, they were all "partyers", drinking and drugging too much of the time. It makes me so sad! What a waste of time!

I completely agree, Bravebuddharich. It turns my stomach to see anyone committing this unnecessary slow suicide by Russian roulette drug abuse, even more so since I lost friends the same way.

But please don't try and tell me that a couple of ecstasy pills every month or whatever will kill me.

Exactly my point, and I don't know why this is so difficult to grasp unless you're of the personality that has no self-discipline and immediately are the type to go overboard and do 5 pills per week. The word "moderation" seems out of the mind set of some, no offense to those posters.

I agree with Philly, moderation is key for most drugs and alcohol. For instance I drink about 10 days out of the 365 days of the years which is not much at all and have done in socially. Pot I probably have done it 3 time a year and I don't think the amountwill kill me. After all we need to live a little.

What I am afraid is that now that I know I am HIV positive and feel like crap and need SOMETHING to lift me up I may over-exceed the amount of liquor and drugs I normally do because after all many of us suffer from severe depression. It take a VERY disciplined person who is not severely depressed to have control of their substance and alcohol intake. HIV makes someone much more vulnerable to substance abuse therefore it is best to stay away from anything harmful.

To me this seems similar to the topic of whether or not two poz people should use condoms. Maybe it's dangerous. Maybe it's not. There simply is no data on this and most opinions strike me as biased conjecture.

It stands to reason that the use of certain drugs, whether legal or not, are bad for you physically. Whether that interacts with HIV is academic in my opinion. Warning someone that certain drugs ruin lives, ruin your health and make you into a worthless pile of bones certainly has zero effect on their popularity, regardless of the hiv status of the users.

We play dice with our lives every day. There are a few things in life we know are dangerous, yet we still choose to do them. There are many other activities in which we engage where no one has ever bothered to measure the degree of danger to the human condition. Hell, for all I know, the radiation from floursescent bulbs is causing cancer in thousands of innocent children as I write this, and I have done nothing to stop it.

I don't like people who use certain drugs. That's my choice. However, it is their right to use them and I strongly defend their right to do what they want with their bodies, regardless of how exquisitiely they annoy me. I myself use other drugs. I have made a choice there as well. I don't smoke marijuana because of its health benefits. I smoke it because I like it. How it effects my HIV is, to me, irrelevant. Any excuse I use to claim that I do so because of its health benefits would be disingenuous.

It strikes me that opinions on this matter fall a little to neatly along the lines as to whether a person feels that illegal drug use should be illegal. My point, I guess, is that debate on this topic seems to be based on fear of drug use and the idea that the law is somehow based on an impeachable ethical standard. We clearly lack the data to form objective opinions on the effect of recreational drug use and hiv progression.

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Floating through the void in the caress of two giant pink lobsters named Esmerelda and Keith.

For example, if you use the chart to look up Efavirenz (Sustiva) and MDMA (Ecstasy), it tells you there is "no clinically significant interaction".

We are NEVER going to stop people who want to use drugs for recreation from using them. Instead of chastising, we should be doing all we can to help people make INFORMED choices. Saying that all drugs are dangerous, without proof to back you up, only has the effect of making people not believe a word you say about drugs. If a drug, used reasonably and in moderation, isn't dangerous, then let's say that. Then when we say that a certain drug is dangerous - when it really is - people might take more notice.

I think drugs should be legalised and regulated. A fair bit of drug damage comes not from the drugs themselves, but the crap put into them (cutting) by dealers... or by governments trying to stop the use of a drug. Anyone remember paraquat?

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

I've used the "bud butter" method also, but the recipe I had called it "cannabutter."

Instead of frying in a pan though, throw the stick of butter in a pot of boiling water to help release the THC. Let it come to a vigorous boil for 30 minutes, strain thru cheesecloth, sit in the frig overnight...and VOILA!

"Butter" for use in and on everything.

Betty Crocker never looked (nor tasted) so good. The problem is eating only 1/2 to 1 brownie. And God help you if you don't.

You guys will know when I have taken your advice, as my blos will become much, much more entertaining. Sid and marty Krofft entertaining.

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"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

Everything in moderation. I doubt that a little dabble here, a smoke there, whatever you fancy is hardly going to be too detrimental. In fact, if it lets you sleep better, or otherwise relieves stress or tension, there may even be a benefit.

However, even drugs most would consider harmless, if abused, can be detrimental. For years, my flatmate has had incredible difficulties tolerating the meds, to the point where it affects his adherence and, hence, his options as he keeps having to change meds. He has constant nausea and diarrhoea and his vision has been getting worse.

About 6 months ago, with the change to Katetra tablets in Aus, he gave up his meds completely out of sheer frustration. However, the nausea, diarhoea and vision problems did not subside. After going through his diet and lifestyle the doc suggested his caffeine intake (something I've telling him for years was the likely reason for his insomnia) may be the problem. I'd estimate that he has around 30 cups a day. All that caffeine was dehydrating him and placing an incredible load on his liver and kidneys.

Since upping his water intake and drasticly cutting his caffeine intake everything has improved. He even has to get a new script for his glasses as his eyesight has improved markedly. Go figure.

Use of methamphetamine is associated with an increased risk of major damage to arteries in the neck and stroke, according to two case reports published in the December 26th edition of Neurology. The cases involved young women who experienced speech difficulties and weakness following use of methamphetamine. The study’s lead author, Wengui Yu commented, "it appears methamphetamine use is toxic to large blood vessels".

Methamphetamine use is an major health and social concern. Studies have suggested that use of methamphetamine can worsen damage to the brain caused by HIV and increase HIV’s ability to replicate in the brain. There is also conflicting evidence regarding methamphetamine’s association with risky sexual behaviour.

The case reports involved two HIV-negative women, aged 36 and 29. Following use of methamphetamine they developed sudden onset speech problems and weakness. Brain scans indicated that both women had experienced severe strokes and that there had been tears to the carotid arteries - the main arteries in the neck leading to the brain. According to a scale used to assess stroke severity, the National Institutes of Health Stroke Scale, the 36-year-old woman received a score of 21. She required treatment with a clot-busting drug known as a tissue plasminogen activator. The 29-year-old woman, required a stent (a tube inserted into the artery) to treat the blockage and received a score of 17. Stroke Scale scores over 16 predict a high probability of death or severe disability.

"This is the first time there's been a possible link between methamphetamine use and carotid artery dissection, a tear in the neck artery," comment the investigators".

Other than methamphetamine use, neither of the women had any other significant risk factors for stroke. Both women recovered with mild to moderate disabilities after they received acute stroke therapy.

Anti-HIV therapy can cause metabolic changes than can increase the long term risk of stroke. Some studies have found higher levels of methamphetamine use amongst HIV-positive individuals than their HIV-negative peers. These case studies will therefore be an issue of concern for HIV-positive users of the drug. It is also worth noting that fatal interaction between methamphetamine and the protease inhibitor, ritonavir, has been observed.

Everyone has brought up some very good points... I also make canna butter... I bake for friends who are going through chemo at a local cancer clinic. We all have a Great time... plus I have to admit... I do smoke a bit of herb with a pipe... very rarely do I drink alcohol it just does not mix well with the meds... and I've tried coke when giving a lecture to be able to get in front of a large group of people... ecstacy today is not the drug from the early 80's so I've not taken the concoction people use today... I've had friends OD... drink themselves to death and commit suicide over the years... moderation and or leaving them alone maybe the best course...

As someone in another thread pointed out, all bets are off when substances like meth or crack or heroin come into play. I am VERY dubious that a significant portion of the population is capable of using those drugs recreationally for ANY period of time.

Alcocol is, in my opinion, not a very useful terapeutic drug. It delivers fitful and interrupted sleep, is rough on the liver (especially for those taking HAART) and has a cumulative effect that can prove dangerous if not deadly.

I believe, and I forget who said this. Ambrose Pierce? Anyhow, someone said:

Everything in moderation, INCLUDING moderation.

I rather like that. In my personal experience, I have yet to meet a meth - or crank, or glass or Ice or crank - user who employed, for any length of time, that concept of moderation.

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"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

I am VERY dubious that a significant portion of the population is capable of using those drugs recreationally for ANY period of time.

Well, meth is or at least a couple of years ago widely used in the gay community and since it is highly addictive people can rebound it easily. I am not going to make a list of what drugs are considered "heavy" or what drugs are safe to take in moderation. Like you said, moderation will not kill you or affect your CD4 counts (no proof like many have mentioned) but doesn't it usually start with just a little puff of pot, then try coke and then other things? I don't know many people who go straight to heroin or meth, oh wait I have no proof of this so I guess I am wrong.

I'd have to agree with JK about alcohol.As many of you would know, I had a hell of a time with my liver last year after I started meds. My tolerance level to alcohol is virtually zip, and if there is anything that is going to prevent me from taking my next dose of HAART, it is the vomiting and nausea I get after only a couple of bevvies.

IHaveHope, I am afraid by the tone of your post I have insulted you by my use of scientific data to form an assertion. I urge you to place me on ignore if this bothers you, as I do this with every topic which is scientifically quantifiable from meds to "cures" to treatment options to drugs, legal and not. I am data driven. And it's keps me alive through several bouts of PCP and cancer and other OIs for over fourteen years. I am a skeptic, and I need to see the data before I come to a conclusion. It's a way of life I HIGHLY recommend for anyone dealing with a terminal illness and the toxic meds which can transform it into a chronic one. I have no intent on changing that paradigm, nor, to be honest, do I have much tolerance for people who ignore, belittle or dismiss scientific data and ongoing research. This shit is just too serious to blindly trust anyone.

Insofar as your argument is concerned, I am sure passing judgment on those who use marijuana will keep them from the slippery slope towards heroin. I have not, however, seen much in the way of data that suggests that pot is the "gateway drug" it was painted to be in the 1980s.

There are p lenty of folks here who smoke/imbibe marijuana, both for pain relief and other medical needs, and for recreation. Would you suggest that they switch to the legal alternative, alcohol? Given the impact of HAART on the liver, as opposed to the impact of marijuana on the lungs, which do you find to be the safer option?

And of course, an expected retort wold be "neither." In which case I urge you to check your caffeinne intake, nicotene use, overindulgence in fatty or salty foods, and other problematic substances which can be abused and which pose significant and SPECIFIC problems for the HIV infected.

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"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

IHaveHope, I am afraid by the tone of your post I have insulted you by my use of scientific data to form an assertion. I urge you to place me on ignore if this bothers you, as I do this with every topic which is scientifically quantifiable from meds to "cures" to treatment options to drugs, legal and not. I am data driven. And it's keps me alive through several bouts of PCP and cancer and other OIs for over fourteen years. I am a skeptic, and I need to see the data before I come to a conclusion. It's a way of life I HIGHLY recommend for anyone dealing with a terminal illness and the toxic meds which can transform it into a chronic one. I have no intent on changing that paradigm, nor, to be honest, do I have much tolerance for people who ignore, belittle or dismiss scientific data and ongoing research. This shit is just too serious to blindly trust anyone.

Insofar as your argument is concerned, I am sure passing judgment on those who use marijuana will keep them from the slippery slope towards heroin. I have not, however, seen much in the way of data that suggests that pot is the "gateway drug" it was painted to be in the 1980s.

There are p lenty of folks here who smoke/imbibe marijuana, both for pain relief and other medical needs, and for recreation. Would you suggest that they switch to the legal alternative, alcohol? Given the impact of HAART on the liver, as opposed to the impact of marijuana on the lungs, which do you find to be the safer option?

And of course, an expected retort wold be "neither." In which case I urge you to check your caffeinne intake, nicotene use, overindulgence in fatty or salty foods, and other problematic substances which can be abused and which pose significant and SPECIFIC problems for the HIV infected.

Nah, I ain't mad at ya Jonathon. No reason to block u, it's a forum where people have opinions. anyway girl, you need to if u need to read it from a scientific magazine and verified by the FDA and have multiple clinical trials and others are just need to see with their own eyes. You make alot of sense and I agree with most of what you say.

when considering all 15 studies (i.e., those that met both strict and more relaxed criteria) we only noted that regular cannabis users performed worse on memory tests, but that the magnitude of the effect was very small. The small magnitude of effect sizes from observations of chronic users of cannabis suggests that cannabis compounds, if found to have therapeutic value, should have a good margin of safety from a neurocognitive standpoint under the more limited conditions of exposure that would likely obtain in a medical setting."Source: Grant, Igor, et al., "Non-Acute (Residual) Neurocognitive Effects Of Cannabis Use: A Meta-Analytic Study," Journal of the International Neuropsychological Society (Cambridge University Press: July 2003), 9, pp. 687-8.

A few of the editorial boards that have endorsed medical access to marijuana include: Boston Globe; Chicago Tribune; Miami Herald; New York Times; Orange County Register; and USA Today.

Many organizations have favorable positions (e.g., unimpeded research) on medical marijuana. These groups include: The Institute of Medicine, The American Cancer Society; American Medical Association; Australian Commonwealth Department of Human Services and Health; California Medical Association; Federation of American Scientists; Florida Medical Association; and the National Academy of Sciences

The Controlled Substances Act of 1970 established five categories, or "schedules," into which all illicit and prescription drugs were placed. Marijuana was placed in Schedule I, which defines the substance as having a high potential for abuse, no currently accepted medical use in the United States, and a lack of accepted safety for use under medical supervision. To contrast, over 90 published reports and studies have shown marijuana has medical efficacy.

The DEA's Administrative Law Judge, Francis Young concluded: "In strict medical terms marijuana is far safer than many foods we commonly consume. For example, eating 10 raw potatoes can result in a toxic response. By comparison, it is physically impossible to eat enough marijuana to induce death. Marijuana in its natural form is one of the safest therapeutically active substances known to man. By any measure of rational analysis marijuana can be safely used within the supervised routine of medical care."Source: US Department of Justice, Drug Enforcement Agency, "In the Matter of Marijuana Rescheduling Petition," [Docket #86-22], (September 6, 1988), p. 57.

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"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."